The intracranial pressure curve correlates to the pulsatile component of cerebral blood flow

Research output: Contribution to journalArticle

Abstract

Current methods to measure cerebral blood flow (CBF) in the neuro critical care setting cannot monitor the CBF continuously. In contrast, continuous measurement of intracranial pressure (ICP) is readily accomplished, and there is a component of ICP that correlates with arterial inflow of blood into the cranial cavity. This property may have utility in using continuous ICP curve analysis to continuously estimate CBF. We examined the data from 13 patients, monitored with an intraventricular ICP device determining the pulsatile amplitude ICPamp as well as the area under the ICP curve (AUCICP). Using an elastance measurement, the ICP curve was converted to craniospinal volume (AUCΔV). The patients were examined with Phase Contrast Magnetic Resonance Imaging (MRI), measuring flow in the carotid and vertebral arteries. This made it possible to calculate CBF for one cardiac cycle (ccCBFMRtot) and divide it into the pulsatile (ccCBFMRpuls) and non-pulsatile (ccCBFMRconst) flow. ICP derived data and MRI measurements were compared. Linear regression was used to establish wellness of fit and ANOVA was used to calculate the P value. No correlation was found between ICPamp and the ccICPMRpuls (P = 0.067). In contrast there was a correlation between the AUCICP and ccCBFMRpuls (R2 = 0.440 P = 0.013). The AUCΔV correlated more appropriately with the ccCBFMRpuls. (R2 = 0.688 P < 0.001). Our findings suggests that the pulsatile part of the intracranial pressure curve, especially when transformed into a volume curve, correlates to the pulsatile part of the CBF.

Details

Authors
Organisations
External organisations
  • Skåne University Hospital
  • Mayo Clinic Minnesota
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Radiology, Nuclear Medicine and Medical Imaging

Keywords

  • Cerebral blood flow, Intracranial pressure, Mathematical analysis, Monitoring, Phase contrast magnetic resonance imaging
Original languageEnglish
Pages (from-to)77-83
JournalJournal of Clinical Monitoring and Computing
Volume33
Issue number1
Early online date2018 Mar 16
Publication statusPublished - 2019 Feb
Publication categoryResearch
Peer-reviewedYes

Related research output

Mårten Unnerbäck, 2019, Lund: Lund University: Faculty of Medicine. 88 p.

Research output: ThesisDoctoral Thesis (compilation)

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